Empowering youth to navigate health care
The Imprint is highlighting each of the policy recommendations made this summer by the participants of the Foster Youth Internship Program, a group of seven former foster youth who have completed congressional internships.
The program is overseen each summer by the Congressional Coalition on Adoption Institute, a Washington, D.C.-based nonprofit that raises awareness about the needs of children without families. Each of the participants crafted a policy recommendation during their time in Washington, D.C.
Today we highlight the recommendation from Ash Barcus, 26, a student at Rutgers University.
The Proposal
Barcus calls on Congress to require states to create a “central, electronic access point” for the medical records of foster youth that can be accessed by youth, social workers and other parties to a case that are deemed relevant. They would also have the Children’s Bureau and the Centers for Medicare & Medicaid Services collaborate on a training module on best practices for supporting foster youth with disabilities and chronic illness.
Barcus also calls for every current and former foster youth to be paired with a health care navigator.
The Argument
The Affordable Care Act guarantees Medicaid eligibility for those who age out of foster care until age 26. And while Medicaid coverage and policy varies from state to state, the Early and Periodic Screening, Diagnostic, and Treatment services — meant to guarantee early attention to the health needs of low-income youth — are a requirement for every state plan.
But for youth who experience multiple placements in foster care — Barcus writes that they had 33 in six years — those guarantees do little to ensure a coherent and continuous experience in the complicated health care system. Barcus points out that federal efforts were made to better coordinate foster youth health care in 2008, but writes that “in practice, care, coordination, and maintenance of medical records continues to fall short, particularly for young people in care like myself, suffering with disabilities and chronic conditions.”
In Their Own Words
“Among other ailments, I suffered from frequent, severe migraines, yet during one of my congregate care placements, the staff would often bang keys on the door yelling at me to wake up, and then barge into my room, turn on the lights, and take my blankets away.”
The Imprint’s Take
Barcus hones in on two holes in the logic when it comes to the health care for current and former foster youth. The first is that just because Medicaid has been guaranteed to this group through 26, it is working; the second is that instructing states to coordinate better will mean that happens.
Their central solutions make sense: include youth in a digitized portal so they don’t need to always have to rely on child welfare workers, and connect them to professionals who are paid to help them navigate the byzantine world of health care claims and decision-making.
Left unsaid in their proposal is who will pay for this. Our instinct is that the surest way to give the concept teeth would be to put it on Medicaid, and somehow make coordinated care for foster youth up to age 26 a categorical requirement for all states. We suspect that health care modules could be part of the process for states building new Comprehensive Child Welfare Information System; perhaps a special one-time allocation could be made to help any of those states build something like Barcus describes here.
